Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 24 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.
● Uncommon life threatening pneumonia that may be community acquired or hospital acquired (Centers for Disease Control)
● Traditionally caused by S. aureus, but infections by S. epidermidis are increasing (eMedicine)
● Variable clinical presentation, but patients are acutely ill, often with septicemia or a viral infection
● High risk: comatose patients, neurosurgery or HIV+ patients
● Abscesses and empyema are common complications, have high rate of severe morbidity and mortality
● Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia can be deadly (Clin Microbiol Rev 2010;23:616); both community and hospital acquired cases are developing resistance to clindamycin, but are sensitive to trimethoprim/sulfamethoxazole (Am J Med Sci 2011 Aug 3 [Epub ahead of print])
● Panton-Valentine leukocidin (PVL) is a rare (<5% of stains) Staphylococcus aureus cytotoxin which causes WBC destruction and tissue necrosis; emerging as a serious problem worldwide (Clin Infect Dis 1999;29:1128, Wikipedia)
● No vaccine available (BMC Public Health 2011;11 Suppl 3:S27)
● Radiology patterns includes lobar or miliary
● Rapid test uses gram stain and bacterial ATP assay on BAL fluid (Arch Pathol Lab Med 2005;129:78)
● Pyogenic response with tissue destruction
Necrotizing pneumonia in neonate
End of Lung-nontumor > Infections > Staphylococcus aureus
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